Epidemiology, risk factors, diagnosis, and microbiology of suppurative pyelonephritis: a systematic review and meta-analysis, part 1
Abstract
INTRODUCTION
The first part of a systematic review and meta-analysis addressing the problem of purulent pyelonephritis is presented in the article.
AIM
To analyze the epidemiology, predisposing factors, diagnostic approaches, and microbiological characteristics of purulent pyelonephritis, which is a complicated form of acute pyelonephritis characterized by renal parenchymal suppuration, sepsis, or localized abscess.
MATERIALS AND METHODS
A systematic review of 46 studies (1981-2024) on complicated pyelonephritis was performed. The review included clinical series (observational and one randomized trial) with more or equal 10 patients reporting on prevalence, risk factors, clinical course, diagnostic approaches, microbiology, treatment, and outcomes of severe pyelonephritis. Data were synthesized qualitatively, and a meta-analysis of key outcomes (mortality and need for surgical intervention) was carried out using a random-effects model.
RESULTS
Acute pyelonephritis is one of the most common serious urinary tract infections, with an annual incidence of 15-17 per 10,000 women and 3-5 per 10,000 men. In most cases, the disease responds well to antibiotic therapy; however, in 20-30% of patients complicated pyelonephritis develops. Predisposing factors include diabetes mellitus, urinary tract obstruction, advanced age, male sex, immunodeficiency, and pregnancy. Diabetes mellitus is present in 30-35% of hospitalized patients with pyelonephritis (vs. 10-15% in uncomplicated cases)…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 10,000 participants or records.
Read the paper
Related studies
- Association of lower urinary tract symptoms and OAB severity with quality of life and mental health in China, Taiwan and South Korea: results from a cross-sectional, population-based study
- Ten-Day Quadruple Therapy Comprising Low-Dose Rabeprazole, Bismuth, Amoxicillin, and Tetracycline Is an Effective and Safe First-Line Treatment for Helicobacter pylori Infection in a Population with High Antibiotic Resistance: a Prospective, Multicenter, Randomized, Parallel-Controlled Clinical Trial in China
- The Role of the NLR and PLR in Urinary Tract Infection
- Threat of Antimicrobial Resistance among Pilgrims with Infectious Diseases during Hajj: Lessons Learnt from COVID-19 Pandemic
- Leclercia adecarboxylata urinary tract infection in a patient with bladder cancer and recurrent hematuria
- A Case Series of Staphylococcus lugdunensis Infection in Cancer Patients at an Academic Cancer Institute in the United States
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.